Journal Article Epublish
PubMed: 40405003 DOI: 10.1038/s43856-025-00908-5
Post-recovery viral shedding shapes wastewater-based epidemiological inferences.
Commun Med (Lond) 5(1):193
Authors: Tin Phan, Samantha Brozak, Bruce Pell, Stanca M Ciupe, Ruian Ke, Ruy M Ribeiro, Anna Gitter, Kristina D Mena, Alan S Perelson, Yang Kuang, Fuqing Wu
Affiliations
- Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, NM, USA.
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ, USA.
- Department of Mathematics and Computer Science, Lawrence Technological University, Southfield, MI, USA.
- Department of Mathematics, Virginia Tech, Blacksburg, VA, USA.
- Virginia Tech Center for the Mathematics of Biosystems, Blacksburg, VA, USA.
- Department of Environmental and Occupational Health Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
- Santa Fe Institute, Santa Fe, NM, USA.
- Department of Environmental and Occupational Health Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Abstract
BACKGROUND
The prolonged viral shedding from the gastrointestinal tract is well documented for numerous pathogens, including SARS-CoV-2. However, the impact of prolonged viral shedding on epidemiological inferences using wastewater data is not yet fully understood.
METHODS
To gain a better understanding of this phenomenon at the population level, we extended a wastewater-based modeling framework that integrates viral shedding dynamics, viral load data in wastewater, case report data, and an epidemic model.
RESULTS
Our results indicate that as an outbreak progresses, the viral load from recovered individuals gradually becomes predominant, surpassing that from the infectious population. This phenomenon leads to a dynamic relationship between model-inferred and reported daily incidence over the course of an outbreak. Sensitivity analyses on the duration and rate of viral shedding for recovered individuals reveal that accounting for this phenomenon can considerably advance prediction of transmission peak timing. Furthermore, extensive viral shedding from the recovered population toward the conclusion of an epidemic wave may overshadow viral signals from newly infected cases carrying emerging variants, which can delay the rapid recognition of emerging variants based on viral load.
CONCLUSIONS
These findings highlight the necessity of integrating post-recovery viral shedding to enhance the accuracy and utility of wastewater-based epidemiological analysis.
MeSH
Viral Load, Recycling, Virus Shedding, Epidemics